Health Care Systems

The Health Economists’ Study Group (HESG) was founded in 1972 to support and promote the work of health economists. Its members are from academic, commercial, and government settings. The purpose of HESG is to transmit knowledge and ideas, ranging from the theoretical to very practical policy issues.

OHE’s participation at the 33rd Meeting of the Spanish Health Economics Association (AES) last week reported the results of four research projects. Jorge Mestre-Ferrandiz, OHE’s Director of Consulting, presented OHE’s recent research on projecting medicines expenditures in the NHS using a bottom-up, rather than a top-down, approach.

In this video, Adrian Towse discusses the challenges and importance of appropriately valuing genomic medicine. He addresses both gene therapies and “pharmacogenomics” -- those medicines that will allow targeted, precision treatment.

Professor Alan Maynard of the University of York, who will speak on Contracting for Quality in the NHS: Putting the Francis Report in Perspective.

Traditionally, decision makers both within and outside the health sector have thought of the value of health interventions primarily in terms of reduced morbidity or mortality. Health care, however, produces wealth effects outside the health care sector—for example, improvement in labour productivity for both patients and caregivers, cost savings in health and social care and other sectors, and an increase in national income.

The 2013 conference of the Association of the British Pharmaceutical Industry (ABPI) addressed the challenges and opportunities presented by the recent changes in the NHS. Understanding quality, and setting and meeting standards for quality, are essential going forwards. At the conference, OHE’s Adrian Towse reviewed the experiences and concerns that have shaped the approach to quality and identified critical components.

Advances in science and technology are producing more and better means for diagnosing disease, matching patients to the best therapies, and tracking the progress of treatment. The potential impact of using diagnostic and therapeutic tests in tandem with treatment—“co-dependent technologies”—potentially can maximise both treatment effectiveness and economic efficiency.

Performance-based risk sharing arrangements for prescription medicines and other treatments are attractive to payers because they promise to base what is paid for a treatment on whether/how well it actually works. Programmes typically include data collection and either implicitly or explicitly link pricing, reimbursement and/or revenue to what the data show.

OHE’s Koonal Shah is a co-investigator in research intended to define public preferences about allocating health care resources to patients who are at the end of life. In late March, OHE hosted a Lunchtime Seminar that examined both the approach and the results of research to date.

Medicines account for less than 10% of total NHS expenditure in the UK. Because spending on medicines is easy to separate out, however, this sector continues to come under particular scrutiny in efforts to manage costs. Forecasting spending on medicines can be useful in planning NHS resource allocation.

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